TMJ surgery is prescribed when it's determined that structural problems are causing pain and limited jaw movement. Repairing or removing the disc between your mandible and temporal bone may prove beneficial in some instances. If you have advanced osteoarthritis, a partial or total joint replacement may relieve symptoms by improving your joint mechanics and motion.
The four most common types of surgery for TMJ are arthrocentesis, arthroscopy, arthroplasty, and open joint. The nature of your condition will determine which TMJ surgery is recommended.
Arthrocentesis TMJ Surgery -- An out-patient procedure, arthrocentesis is performed under general anesthesia. It is used to treat patients without a significant history of TMJ who experience a sudden onset of restricted jaw opening. This procedure involves washing out the affected joint with saline administered through a needle. The goal is to lubricate the joint, loosen scar tissue and improve the range of motion. Occasionally, arthrocentesis surgery for TMJ requires removing tissue adhesion bands and dislodging the disc that is stuck in front of the "ball" portion of the temporomandibular joint's "ball and socket."
Arthroscopy TMJ Surgery -- A minimally invasive out-patient procedure requiring general anesthesia, arthroscopy involves inserting a tiny surgical instrument containing a light and a lens through a small incision in front of the ear. This instrument is connected to a video screen which allows the TMJ specialist to examine the temporomandibular joint, remove inflamed tissue and realign discs. Arthroscopy surgery for TMJ has many benefits including less scarring, fewer complications and shorter recovery time than many other procedures.
Arthroplasty TMJ Surgery -- More complicated cases of TMJ may require an arthroplasty. Typically an inpatient procedure, arthroplasties are most often used for disc repositioning, tissue grafts and gap arthroplasty. These procedures involve making an incision along the ear so the joint space can be examined and adhesions removed, bone spurs shaved and discs sutured or replaced.
Open-Joint TMJ Surgery -- There is a wide range of surgical procedures that fall under this category. As the name implies, open-joint TMJ surgery requires opening the area around the temporomandibular joint so the surgeon has better access to the affected area. These procedures are used to treat deteriorating bone, tumors around the TMJ and scarring or bone chips in the joint. All are performed on an in-patient procedure basis. Recovery time is longer and the likelihood of scarring or nerve damage is greater than with arthroscopic TMJ jaw surgery.
Total Joint Replacement TMJ Surgery -- Considered a "final option," this in-patient procedure involves replacing the natural temporomandibular joints with prostheses. A multi-day hospital stay and extended recovery period should be anticipated.